Aurore Ughetto, Miloud Cherbi, Nicolas Lamblin, Laurent Bonello, Guillaume Leurent, Bruno Levy, Meyer Elbaz, Stéphane Manzo-Silberman, Pascal Lim, Francis Schneider, Alain Cariou, Hadi Khachab, Jeremy Bourenne, Marie-France Seronde, Brahim Harbaoui, Gerald Vanzetto, Charlotte Quentin, Hamid Merdji, Nicolas Combaret, Benjamin Marchandot, Benoit Lattuca, Patrick Henry, Edouard Gerbaud, Danka Tomasevic, Etienne Puymirat, François Roubille, Clément Delmas
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引用次数: 0
Abstract
Objective: Cardiogenic shock (CS) in patients with left ventricular hypertrophy (LVH) due to hypertrophic cardiomyopathy (HCM) or hypertensive heart disease, is underreported in the literature. This study aimed to delineate the characteristics, management strategies, and outcomes of patients experiencing CS with preexisting LVH and HCM.
Methods: FRENSHOCK is a prospective multicenter registry including 772 unselected CS patients from 49 centers. Baseline characteristics, management, and 1-year outcomes were analyzed according to the occurrence on preexisting LVH.
Results: Among the 772 included patients with CS, CS occurred in 34 patients with preexisting LVH (4.4%, 1.4% with HCM). Clinical characteristics, medical history, usual medications, and hemodynamic parameters upon inclusion did not differ between the patients with or without LVH. Left ventricular ejection fraction in patients with CS and LVH was 27.3 ± 14.5% indicating a non-obstructive cause of CS. In-hospital management according to the LVH and non-LVH groups indicated no differences between the groups. The 1-month and 1-year mortality did not differ between patients with CS with and without LVH (26.5% vs. 26%, adjusted HR [hazard ratio] [95% CI]: 0.87 [0.44-1.72]) and 55.9% vs. 44.7%, respectively (adjusted HR [95% CI]:0.88 [0.54-1.42]). Subgroup analyses comparing HCM (n = 11) and hypertensive LVH (n = 23) revealed similar clinical characteristics, in-hospital management, and one-year rehospitalization rates in these patients.
Conclusion: In a large and unselected CS population, the prevalence of patients with LVH was low (4.4%) with less than half having HCM (1.4%). The presentation, management, and outcomes of CS were similar to the broader CS population in our series. However, HCM-CS represents a distinct clinical entity necessitating tailored management approaches.
期刊介绍:
The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments.
Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.